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FEC FORM 1

STATEMENT OF ORGANIZATION

FILING FEC-1026630

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1. Innovation PAC

    203 South Union Street
    STE 300
    Alexandria, VA 22314
    Email: dbacker@dbcapitolstrategies.com;joe@dbcapitolstrategies.com

    NOTE: Email address is different than previously reported

2. Date: 10/02/2015

3. FEC Committee ID #: C00486837

This committee supports/opposes more than one Federal candidate and is NOT a separate segregated fund or a party committee.

Affiliated Committees/Organizations

NONE
, ____

Custodian of Records:

Dan Backer
203 South Union Street
STE 300
Alexandria, VA 22314
Title: Treasurer
Phone # (202) 210-5431

Treasurer:

Dan Backer
203 South Union Street
STE 300
Alexandria, Virginia 22314
Title: Treasurer
Phone # (202) 210-5431

Designated Agent(s):

Joseph Lilly
203 South Union Street
Suite 300
Alexandria, Virginia 22314
Title: Assistant Treasurer
Phone # (202) 210-5431

Banks or Depositories

Access National Bank
4221 Walney Road
Suite 120
Chantilly, Virginia 20151

Signed: Dan Backer
Date Signed: 10/02/2015
Official Committee URL: http://www.InnovationPAC.org

(End FEC FORM 1)

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